Basic Information
Provider Information
NPI: 1043746589
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAYON
FirstName: DANIEL
MiddleName: RENE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: DEPARTMENT OF ORTHOPEDIC SURGERY
Address2: MSC 82 33-04-05, 660 SOUTH EUCLID AVE
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3147475697
FaxNumber: 3147472598
Practice Location
Address1: 660 SOUTH EUCLID AVE
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 63110
CountryCode: US
TelephoneNumber: 3147475697
FaxNumber: 3147472598
Other Information
ProviderEnumerationDate: 05/03/2017
LastUpdateDate: 08/17/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X2022010870MOY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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